Combining aerobic, resistance exercise may be best for diabetes

NEW YORK (Reuters Health) - Exercise programs that combine
aerobic exercise and resistance training may be better at
helping people with diabetes control their blood sugar than
either type of exercise alone, a new analysis of past studies
says.

"It has been well established that exercise training is
better than doing nothing," Lukas Schwingshackl told Reuters
Health in an email. He led the study at the University of Vienna
in Austria.

"One of the more important questions that remains to be
answered is which exercise modality offers the most benefits,"
Schwingshackl added.

He said that previous reviews found exercise programs to be
beneficial for blood sugar control but none made head-to-head
comparisons of aerobic exercise, resistance training and a
combination of the two.

For their review, Schwingshackl and his colleagues searched
for studies that had randomly assigned people with diabetes to
different exercise programs lasting at least eight weeks.

They found 14 studies with a total of 915 participants that
met their criteria.

The researchers found that aerobic exercise appeared to be
more effective than resistance training at reducing HbA1C, a
measure of blood sugar control, and fasting blood sugar.

Combined training programs were even more effective than
aerobic exercise alone for reducing HbA1C and more effective
than resistance training alone for reducing HbA1C, fasting blood
sugar and triglycerides, according to the results published in
Diabetologia.

Many of the studies were of low quality and all of them
involved supervised training only, the researchers note. They
say that in the real world, it's more likely that people would
exercise on their own.

Future studies of long-term exercise programs assessing
rates of heart disease and death among people with diabetes, for
instance, "are needed to develop definitive recommendations,"
Schwingshackl said.

He said the American College of Sports Medicine has stated
that combining resistance training and aerobic exercise for at
least 150 minutes of moderate-intensity exercise per week may be
more effective at improving blood sugar control than focusing
solely on one type of training.

"I think it's really important for people with diabetes to
remember that exercise is a critical component of being well -
you can't do it with just diet," Dr. Patrick McBride told
Reuters Health. He was not involved in the study.

McBride, who runs a diabetes prevention and management
program at the University of Wisconsin Hospital in Madison, said
that regular exercise can help lower blood sugar levels.

"I always tell people that if they exercise more than 30
minutes they'll burn up blood sugar for 24 hours," he said.

Having a combined program of aerobic exercise and strength
training is important, McBride added.

"We always talk about how fitness is being strong and having
good endurance and being flexible - so it's good to have a
combined program," he said. "That's what the emphasis of this
study was, being both strong and having good endurance - that
was best for people with diabetes."

McBride said that people who have diabetes or want to
prevent diabetes can find personal trainers who are exercise
physiologists at most good health clubs and YMCAs.

"These are people with degrees in exercise science and they
know all about this," he said.